4875 ALPINE DR 2022-01-24 - Laserfiche WebLink

Irk MINN • I. PIN3LIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 'tS'i5-- ilia SITE WORK FOR PROJECT TYPE: FR-DETACHED ❑TOWNHOUSE EIDUPLEX ❑ADU EMULTI-FAMILY EICOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.) IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# DESCRIPTION OF SITE WORK 1 RIGHT-OF-WAY WOR FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATI QUESTIONS: ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: DRIVEWAY APRON/CURB CUT FT WIDE ❑Combined Sewer SPHALT/CONCRETE PAVING Sl./ SF Separated Storm Sewer ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑Direct Discharge to Snohomish River or Puget Sound ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑CLEARING/GRADING/FILL/EXCAVATE CY Ei MR2 Only ❑MR1-5 ❑ MR1-9 LI CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 1,..5-6O SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: V 5.60 SF CONTACT INFORMATION OWNER/APPLICANT NAME: P n �\ /1 I OWNER/APP. MAILING ADDRESS: BEET 4f 7 j i, III Q_0' , CfTY ' 0 . STATE ` ZIP OWNER/APP.PHONE:q 5'039 i 4 OWNER/APP.EMAIL: Baer ar ae�� tCC( `Required for Work in Public Right-of-Way / CONTRACTOR NAME: �� (�f f ",'f�,q( 3/� �� 1�CJI� CONTRACTOR ADDRESS: Ir' STREET "C� ' �1 Y l lin CnY 4' / / STATE r ZIP i"l I�Q� I CONTRACTOR PHONE: l 'ita 0 CONTRACTOR EMAIL: 1✓ .7 CONTRACTOR LICENSE#(RE UIRED):P AIWl,. j N. EVERETT BUSINESS LICENSE EQUIRED PRIMARY CONTACT: OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect,Engineer, Etc.) CO_N ACT NAME:^ \ / , c,� ( ) (� CONTACT PHONE: I-k a5 S � — �(,�,.� l , L (�[�� CONTACT EMAIL: 1 y) L Ik sr.,,[_.,// ' cgJ gp t ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contain herein is true and correct. Work(Arne pursuant to .e it ust e vyt comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must firs authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is mad and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only OF , PERMIT# g er/Au h riz' d A Si at a Date/ (Revised 1/72019) r